RingMD began as lines of python code written on a bus, expanded across more than a dozen countries, and evolved into infrastructure for healthcare organizations and public agencies.
The mission remained constant. Our understanding of the work did not.
In October 2012, I was on a bus from Jakarta to Bogor when it stopped for fuel. I saw an elderly couple, and a young child washing up and somewhat drinking from a roadside gutter. In the woman's hand, an Android phone streamed YouTube.
The juxtaposition impacted me.
The thought that followed was almost embarrassingly literal: if video could reach that phone, why couldn't a doctor?
Perhaps with the rise of affordable smartphones and widespread mobile internet connectivity, one could make a dent on bringing affordable healthcare access to the more than 3 billion people who lacked it.
Before the bus reached Bogor, I began coding.
At the time, I thought the main obstacle was distance. I was right, but only about the visible (and obvious) part of the problem.
The First Answer
Over the following weeks, I built the earliest version of what became RingMD. It was essentially a directory of doctors, with photographs, consultation prices, professional experience, and résumé information. The first doctor on RingMD practiced at Mount Elizabeth Hospital in Singapore.
Patients would be able to find doctors and consult them online. Joining would be free, and the platform would retain a small fee (about five percent) when a consultation occurred.
The product was modest. However, the goal was much more significant. The mission was to make the belief that affordable healthcare should be reachable regardless of where someone lived a reality.
RingMD was not a master plan. I was managing a software-development company remotely while traveling through Southeast Asia. It was a side project built around a question I kept returning to.
RingMD launched publicly in December 2013. Our first Android application followed in November 2014. By 2015, RingMD was a Singapore-incorporated company, and I was working on it full time. We had raised approximately $500,000 in seed financing and I contributed another $500,000 personally, putting every dollar in my name into the company and mission. We built a team of 12 people, and supported hundreds of doctors and thousands of consultations.
The early product was a marketplace. Doctors could make themselves available, set their rates, and consult patients online. The appeal was obvious. Geography should not determine whether someone could reach appropriate medical care.
Then the company began moving quickly.
In 2016, RingMD raised approximately $10 million in Series A financing. In less than 16 months, our team grew from approximately 12 people to nearly 3000, with colleagues working across more than 12 countries. We entered new markets, expanded the platform, signed distribution partnerships, and reached more than 38 million people through a combination of consultations and health-information services.
Investors encouraged us to move faster. Much of the team agreed, and so did I. The reason was not simply valuation. We could see RingMD reaching more people, and speed appeared inseparable from impact.
While the belief was not false, it turned out to be incomplete.
The outside world largely rewarded reach. Microsoft profiled RingMD’s work. We made health information available through Facebook's Free Basics platform and built a health chatbot for Skype. In 2018, Singapore's Ministry of Health selected RingMD for its first telemedicine regulatory sandbox, which we helped shape.
Those milestones were surprisingly important. But simply reaching someone was not the same as caring for them dependably.
A doctor could appear on a screen. The harder question was what had to work behind it.
Experience in India Changes the Core Question
Digital India had launched in July 2015. The following February, contemporaneous reports announced an agreement to make RingMD available through India's Common Services Centre network.
From my direct involvement, we licensed a customized RingMD deployment for use through that national system. The program was intended to reach 250,000 village-level service points. Imagine a convenience store or simple brick-and-mortar location where people in rural areas could visit, use a computer or tablet, and access common services like online medical appointments, banking and education. RingMD eventually scaled across more than 250,000 Common Service Center locations across India. The growth was incredibly challenging, yet indescribably humbling and rewarding.
However, a key distinction matters. Announcing national reach and making a national system work are different objectives and achievements.
We had to build a separate India deployment with in-country hosting, Aadhaar-based identity verification, and an integration with government payment systems. The platform also had to perform in low-bandwidth environments and fit the work of the local operators helping people use it. We faced numerous technical challenges with low-bandwidth video calls and had to get creative on how we managed peer-to-peer encrypted comms.
A Microsoft account of the deployment described Priyanka Bali, who operated a Common Services Centre serving five villages in the Himalayan foothills. She tested RingMD herself for a rash before helping other villagers use it. Her center placed the computer behind a curtain so patients could speak with doctors more privately.
That small physical detail (a curtain inside a village service center) revealed more about access than any national headline could.
The technology worked because it entered a place people already used, with a trusted, local person who could help them navigate it. Identity, payments, language, connectivity, privacy, and trust were not secondary implementation details. Together, they determined whether the doctor on the screen could matter.
India changed how I thought about scale.
A marketplace scales by adding users. Public infrastructure scales by fitting the systems that already organize people's lives and adding value in mission-critical ways.
That lesson eventually became RingMD's organizing principle.
Restructuring Around the Real Product
In 2018, we restructured RingMD. The process included layoffs. Colleagues who had helped build the company were affected, and their contribution remains critical part of its story.
The restructuring also brought new partners into the business with experience building and scaling healthcare technology in the United States. We relocated RingMD’s headquarters from Singapore to the United States. Together, we narrowed the company's focus and prepared it for a different phase of growth.
What kept me and many others committed was the original purpose and mission to make affordable healthcare accessible wherever people lived. The business could change its structure and product, but the reason, the “why”, for building remained.
We reshaped RingMD around a different premise: provide configurable platforms to public healthcare organizations and governments.
An institution did not need another public marketplace. It needed a system that could fit its clinicians, patients, permissions, workflows, reporting requirements, support model, and existing technology. The integrations and workflows seemed endless.
That seems obvious in retrospect. It was something we learned the hard way from the original iteration of RingMD.
The marketplace model emphasized discovery and distribution. This turned out to be critical to honing a user-efficient and friendly interface. The institutional model required integration, security, training, support, and operational reliability.
What we came to realize is that those were not features surrounding the product. They were the product.
Investors, operators, employees, partners, and customers each helped RingMD move through that transition. I wrote the first code. I did not write the second chapter alone.
Less Than Three Hours
In 2020, the new model met its first serious test.
Less than three hours remained before Chile's national COVID-19 platform was scheduled to launch. I was in Charleston on a conference call with Chile's Minister of Health, EY Chile, and the MINSAL team.
RingMD colleagues were working across Charleston, Atlanta, Los Angeles, Singapore, Santiago, and Washington, D.C. Dozens of conference calls had led to this one. This call had a hard deadline.
On our screens was the AI-assisted triage system we had built to help manage incoming COVID patients and route them to appropriate care providers. The Minister of Health was testing the platform. The remaining Spanish-localization changes were minor.
The unresolved problem was not.
The platform needed to authenticate people through Chile's ClaveÚnica service, using the RUN as the identifying number. That handshake with the government system had not been finalized. We were working with MINSAL's IT team to get it functioning before the country arrived at the front door.
The plan was for President Sebastián Piñera to introduce the service on live national television and to demonstrate the platform in real time.
There would be no quiet retry.
It had to work.
EY later described the system as an interactive first point of contact for evaluating COVID-19 symptoms, directing people toward government doctors when the screening identified signs of infection. A contemporaneous RingMD brief hosted by the National Governors Association reported that the nationwide solution was deployed within 72 hours.
According to Ernst & Young and RingMD's launch records, more than 68,000 people tried the service during its first day.
Project records later reported more than 500,000 patients used and 2,000 providers supported by the system. At peak throughput, it carried up to 100,000 video calls per week.
The scale mattered. It met a significant need. But the lessons learned from this experience extended far beyond user metrics. Much further.
The triage tool was what people encountered. Authentication was what allowed them to encounter it. Behind every consultation stood the work of government officials, clinicians, implementation partners, translators, support personnel, and engineers spread across six cities and four countries.
India had taught us that access depended on fitting national systems. Chile showed what happened when every component in those systems was placed under pressure.
The work was no longer only about connecting an individual patient with a doctor. It was about helping an institution respond when an entire country needed a reliable path into care.
From Emergency Deployment to Public Infrastructure
Later in 2020, RingMD participated in Y Combinator's Summer program and raised $2.5 million in SAFE financing. That capital supported continued U.S. growth and the company's institutional and public-sector work.
In July 2021, the Indian Health Service awarded a clinical video telehealth contract to AA RingMD. In October 2022, IHS made the platform available across its federal facilities and described it as the first telehealth-focused platform the agency had deployed.
The practical details mattered. The secure system could be used across multiple devices and in homes or schools with limited broadband. For a patient far from a major medical center, low-bandwidth performance was not a technical specification. It was the difference between having an appointment and being unable to reach one.
In 2024, HHS's Administration for Strategic Preparedness and Response awarded RingMD USA Inc. an indefinite-delivery contract for all-hazards disaster telemedicine. In December 2025, RingMD Telemedicine became FedRAMP Certified through the agency path at Class C (Moderate).
Those achievements describe the institutional side of the work: the security and contracting foundation required before a public agency can depend on a system.
The human side is easier to see in the services now operating through that foundation.
Alaska identifies RingMD as its partner for no-cost, round-the-clock telehealth for people enrolled in two disability-waiver programs. A person confronting a behavioral-health crisis does not experience that service as an infrastructure contract. The person experiences whether a licensed clinician is available at two in the morning.
In Ohio, RecoveryRachel helps people find mental-health and addiction care. Ohio also selected RingMD for a separate 2025 award, to have RingMD build out the state's centralized 988 communications platform.
These programs differ in population, purpose, and scale. The common mechanism is less dramatic than the founding story though. It soon became obvious that we needed to fit the existing institution closely enough that a person can reach the right help when the need is real.
That is what infrastructure looks like from the receiving end.
The Original Question (Revised)
I still think the question on the bus was the right one. Simple, yet profound. I soon came to learn that I had understood only its visible layer.
I asked whether a doctor could reach the screen. Over time, the better question became whether everything behind that screen (people, institutions, and systems) could make the health encounter dependable.
Today, while I remain a committed supporter, I am no longer at the public center of RingMD’s story. That change in vantage point has made many things clearer. If the work is real, it must become less dependent on the person who started it. RingMD's future belongs to the people who operate it, improve it, and rely on it under pressure.
No founder and no company can solve access to healthcare alone. The more proportionate ambition is to leave the system more capable than we found it—more secure, more responsive, and more dependable across distance and crisis.
The story began with a phone in one person's hand in a rural part of the world lacking healthcare access. The work now belongs to everyone responsible for what happens after the screen turns on.
When someone needs care, the system should work.
-Justin Fulcher
A NOTE ON NAMES: RingMD USA Inc. is the current U.S. parent and holding company. AA RingMD is its joint venture with Advancia Aeronautics. RingMD Telemedicine is a product wholly owned and operated by RingMD USA Inc. I use 'RingMD' here for the broader organization.